Vaccination exemption form

(1) The department shall: (a) develop a vaccination exemption form that includes only the following information: (i) identifying information regarding: (A) the student to whom an exemption applies; and (B) the legally responsible individual who claims the exemption for the student and signs the vaccination exemption form; (ii) an indication regarding the vaccines to which the exemption relates; (iii) a statement that the claimed exemption is for: (A) a medical reason; or (B) a personal or religious belief; and (iv) an explanation of the requirements, in the event of an outbreak of a disease for which a required vaccine exists, for a student who: (A) has not received the required vaccine; and (B) is not otherwise immune from the disease; and (b) provide the vaccination exemption form created in this Subsection (1) to local health departments. (2) (a) Each local health department shall designate one or more individuals from within the local health department as a health official to consult, regarding the requirements of this part, with: (i) parents, upon the request of parents; (ii) school principals and administrators; and (iii) licensed health care providers. (b) A local health department may designate a licensed health care provider as a health official designee to provide the services described in Subsection (2)(a). (3) (a) To receive a vaccination exemption form described in Subsection (1), a legally responsible individual shall complete the online education module described in Section 26B-7-118, permitting an individual to: (i) complete any requirements online; and (ii) download and print the vaccine exemption form immediately upon completion of the requirements. (b) A legally responsible individual may decline to take the online education module and obtain a vaccination exemption form from a local health department if the individual: (i) requests and receives an in-person consultation at a local health department from a health official or a health official designee regarding the requirements of this part; and (ii) pays any fees established under Subsection (4)(b). (4) (a) Neither the department nor any other person may charge a fee for the exemption form offered through the online education module in Subsection (3)(a). (b) A local health department may establish a fee of up to $25 to cover the costs of providing an in-person consultation.